Ocular Complications of Systemic Candidemia
Summary
Systemic candidemia, defined by the presence of Candida species in the bloodstream, poses a significant risk of ocular invasion due to haematogenous dissemination. The most frequent manifestation is chorioretinitis, often asymptomatic, which may progress to endophthalmitis if not promptly detected and treated. Key risk factors include infection with Candida albicans, persistent positive blood cultures, neutropenia and central venous catheter retention. The pathogenesis involves fungal traversal of the blood–retinal barrier, leading to local inflammation, retinal dysfunction and, in severe cases, irreversible vision loss. Clinical vigilance is essential: initial fundoscopic examination within the first week of candidemia onset, with repeat assessment after 7–14 days in high-risk patients, improves detection of evolving lesions. Therapeutic management comprises systemic antifungal agents—azoles, echinocandins or amphotericin derivatives—sometimes requiring intravitreal injections or vitrectomy in advanced cases. Advances in drug delivery, host–pathogen interaction models and species-specific profiling inform tailored interventions. Globally, the burden of ocular candidiasis underscores the need for standardised screening protocols, improved antifungal penetration into ocular tissues and novel therapies to preserve vision in affected patients.
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Ocular Complications of Systemic Candidemia publication trend
The graph below shows the total number of articles in ocular complications of systemic candidemia across all publications each year (not limited to Nature Index journals).
Technical terms
Candidemia: Presence of Candida species in the bloodstream, often hospital-acquired and associated with invasive disease.
Chorioretinitis: Inflammation of the choroid and retina layers of the eye, commonly the earliest manifestation of ocular candidiasis.
Endophthalmitis: Severe intraocular inflammation involving vitreous and aqueous humours, risk of permanent vision loss if untreated.
Blood–retinal barrier (BRB): Selective interface between retinal vessels and neural tissue that normally prevents pathogens and toxins from entering the eye.
Biofilm: Structured microbial community embedded in an extracellular matrix, increasing resistance to antifungal agents.
References
- Candida Biofilm Eye Infection: Main Aspects and Advance in Novel Agents as Potential Source of Treatment. Antibiotics (2023).
- Systemic Candida albicans Infection in Mice Causes Endogenous Endophthalmitis via Breaching the Outer Blood-Retinal Barrier. Microbiology Spectrum (2022).
- Risk Factors and Clinical Characteristics of Patients with Ocular Candidiasis. Journal of Fungi (2022).
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